太原市社区卫生服务中心(站)资源配置和社区居民及职工满意度调查

Survey on resource allocation,community residents and employee satisfaction of community health service center(station),Taiyuan city

目的了解太原市社区卫生服务发展现状,为提出推进措施提供有力的事实依据。方法 2012年6~8月招募山西医科大学学生作为调查员,对通过分层随机抽样产生的太原市72家社区卫生服务机构进行调查,内容包括机构资源配置（人力和经费）、基本公共卫生服务功能和居民及职工满意度调查。结果太原市社区卫生服务中心和服务站公卫医师、人员编制配置和政府拨款的基尼系数分别为0.67、0.65和0.79;居民对服务中心（站）的诊疗费用满意度最低,likert评分值仅为2.66和2.78;服务中心和服务站所在社区居民了解居民健康档案的比率分别为19.23%和13.60%;居民建档率分别为65.38%和61.30%;居民就医调用健康档案的比率分别为16.15%和7.28%;非编制员工占服务中心（站）所有职工的55.48%（157/283）,其对收入水平、个人发展和培训机会的满意度得分均在3分以下,低于在编职工（P〈0.01）。结论社区卫生服务公卫医师配置仍有不足;机构员工中多为＂临时工＂,待遇低,缺乏业务技能培训,岗位稳定性差;居民健康档案多为一次性的＂死档＂,不能充分利用;居民对社区卫生服务机构了解程度不高,对其方便性较为满意,对其医疗技术水平和药品价格较不满意。

Objective To understand the current status of development in community health services of Taiyuan city,so as to provide strong factual basis for putting out promotion measures. Methods Students of Shanxi medical university were recruited for the survey.72 community medical service institutions were randomly collected.The contents of the survey included allocation of medical resources,using of the resident health record files and resident satisfaction. ResultsPublic health physicians,official employees and government finance support were allocated not reasonably,the Gini coefficients were 0.674,0.654,and 0.788.The residents of the surveyed communities were the least satisfied with the cost of medical service,the likert values were 2.66 and 2.78 respectively for health service centers and stations.Only 19.23% of local residents around community health service centers and 13.60% around health service stations understood the importance of resident health record files.65.38% and 61.30% of the local residents around health service centers and stations had health record files.Using rate of the resident health archives was 16.15% and 7.28%.55.48% of the staff in the community health service institutions were temporary,and the satisfaction values for income level,personal development and training opportunity were under 3points,significantly lower than formal staff（P〈0.01）. Conclusion Allocation of public health physicians in community health services is still insufficient,most of the staff in the institutions are ＂temporary workers＂,the treatment is low,the lack of vocational skills training,job stability is poor,most of the residents health archives are one-time ＂dead files＂,and can not be fully used;The residents cannot fully understand the community health services,they are satisfied with the convenience,but not with the level of medical skills and drug prices.